System For Preparing Teeth For The Placement Of Veneers

ABSTRACT

Dental instrumentation for use in guiding a cutting tool to remove tooth structure from a working tooth is prepared. A digital model of cutting guide shell structure for placement around a portion of the tooth to be treated is combined with preset tool movements to be made by the cutting tool by one or more processors to define final cutting guide data corresponding to final cutting guide structure for guiding the cutting tool. A digital model of a fixation instrument configuration for fixing the dental instrumentation to an adjacent tooth to the working tooth is combined with the final cutting guide data by one or more processors to define final instrument configuration data corresponding to a final instrument configuration for releasably fixing the dental instrumentation to the adjacent tooth and for guiding the cutting tool in the removal of the tooth structure from the tooth to be treated.

CROSS-REFERENCE TO RELATED APPLICATION

The present application is a divisional of U.S. patent application Ser.No. 15/858,253, filed on Dec. 29, 2017, which claims the benefit of thefiling date of U.S. Provisional Patent Application No. 62/472,372, filedMar. 16, 2017, the disclosure of which is hereby incorporated herein byreference.

FIELD OF THE TECHNOLOGY

The present invention relates to devices, systems, and processes forpreparing a tooth for a tooth restoration, and in particular to systemsand processes for preparing instrumentation, as well as to suchinstrumentation, for use in preparing a tooth to receive a toothrestoration.

BACKGROUND OF THE TECHNOLOGY

Complete, intact teeth that are cosmetically desirable, wear evenly, andprovide a balanced bite are the objectives of patients. Over time,however, problems arise in teeth due to accidents, deterioration fromwear and tear, decay due to any of poor oral hygiene, insufficient oralcare practices, consumption of certain foods such as sweets, use oftobacco, disease, medications, certain congenital conditions, andenvironmental effects, tooth movement, etc. In some instances, teethsimply never achieve a cosmetic appearance desired by a patient. To thisend, dental practitioners and their patients have relied on a variety ofmethods to repair these deformities and weaknesses of the teeth.

The repair of teeth often requires preparation and modification of theexterior shape and size of a tooth to be able to receive variousprostheses or restorations such as crowns, inlays, onlays, bridges, andveneers. Also, to prepare the appropriate prosthesis or restoration,either impressions or 3-dimensional scanning must be conducted of theoriginal unmodified tooth and often the modified tooth at a later time.Dental practitioners often place a temporary prosthesis over themodified or prepared tooth while a permanent prosthesis is manufactured,but the use of such a temporary device and the removal of any cementused to place the temporary device over the prepared tooth may create adiscrepancy between the prepared tooth and the internal configuration ofthe prosthesis.

Recently, systems and methods have been developed by Viax DentalTechnologies, LLC to form a guiding device for use in preparing aworking tooth requiring treatment to receive a restoration along withthe placement of a previously prepared restoration corresponding to theconfiguration of the guiding device during the same visit, thusobviating the need for a temporary prosthesis. Such systems, methods,and devices are disclosed in U.S. Patent Application Publication No.US20100192375 A1, now abandoned; U.S. Patent Application Publication No.US20100196842 A1, now U.S. Pat. No. 8,640,338; and U.S. PatentApplication Publication No. 2014/0248577 A1 (“the '577 Publication”),the disclosures of each of which are hereby incorporated by referenceherein. Still, further improvements are needed to more efficiently andreliably treat the teeth of patients for receiving restorations andother prostheses.

SUMMARY OF THE TECHNOLOGY

In accordance with the present technology, a system, methods, andproducts have been discovered which provide a simpler, more reliable andmore convenient technique for treating a tooth in need of a restorationpart to correct either or both of a deformity and a weakness of a toothor either or both of deformities and weaknesses of a plurality of teeth.There is provided a system of dental devices that may be used to modifya tooth to be treated by limiting the removal of tooth material toproduce a shape or configuration that mates with or corresponds to aninterior configuration of a restoration part. This system makes itpossible to prepare a restoration part in advance of the preparation ofthe tooth to be treated. Also, the tooth can be accurately prepared withthe configuration that corresponds to and mates with the internalconfiguration of the restoration part. By following this technique, therestoration part is available to be installed immediately after thepreparation of the tooth to be treated. Therefore, in a single officevisit, it is possible for the dentist to prepare the tooth to be treatedand mount the restoration part onto the prepared tooth. As used herein,it is to be understood that a reference to a tooth to be treated means asingle tooth to be treated or a plurality of teeth to be treated.

As with conventional methods of treatment, in accordance with thepresent technology, there first may be a diagnosis indicating the needto treat a tooth with a restoration part. The diagnosis may be based oninitial x-rays or other diagnostic techniques, such as but not limitedto magnetic resonance imaging (MRI), handheld or other intraoralthree-dimensional (3D or 3-D) scanners, that identify the location andextent of decay, cracks, weaknesses, dislocations, deformities,impediments to bite, or other maladies or undesirable aspects of thetooth to be treated. A first physical 3D model which may be any one or acombination of a mold, a cast, an impression, other physical model, anda computer-generated model, may be created based on the obtaineddiagnostic information of the original tooth to be treated. At thispoint the present technology may diverge from conventional techniques inpractice. Conventional techniques require the tooth to be revised andreshaped to remove the decay, cracks, and other maladies to leave aprepared tooth with sufficient strength and wear characteristics for thereceipt and permanent attachment to a restoration part. After toothstructure has been removed during preparation of the tooth to betreated, the revised configuration of the prepared tooth is generallydetermined from a second 3D model which may also be any one orcombination of a mold, a cast, an impression, other physical model, anda computer-generated model. The prepared, revised tooth is normallyfitted with a temporary crown, to protect the prepared tooth and providesome comfort for the patient until the restoration part is manufactured,which can take days to weeks. Both the first and the second physical 3Dmodels are then used, usually at an off-site laboratory, to prepare therestoration. The original tooth configuration provided by the firstphysical 3D model provides the basis for determining and preparing theexterior surface of the restoration part while the prepared, revisedtooth configuration provided by the second physical 3D model providesthe reverse or negative of the interior surface of the restoration partto be prepared. The thickness of the restoration part is provided by thedifference between the determined exterior and interior surfaces of therestoration part to be prepared. The first and second physical 3D modelsalso serve to provide the configuration of adjacent teeth to the toothor teeth to receive a restoration such that the eventual restorationproperly aligns and interfaces with the adjacent teeth. These modelsfurther serve to provide the configuration of antagonist teeth which isused to preparing the occlusal surface of the restoration such thatthere will be appropriate occlusion contact between the restoration andthe antagonist teeth.

The procedure of the present technology reduces inconveniences topatients such as eliminating one or more office visits and eliminatingthe need for wearing a temporary crown. With this technology, there isno need to prepare the tooth to be treated prior to producing therestoration part. There is also no need to produce a physical 3D modelfor the prepared tooth prior to installing the restoration part. Thereis no need for a temporary crown to be installed over the preparedtooth, and thus there is no need to remove the temporary crown andassociated cement which can interfere with the fit of the restorationpart. Complications due to such interference may require the preparedtooth to be further revised to fit the restoration or require furthermodification of the restoration part. Also eliminated is discomfort tothe patient in wearing a temporary device and the greater risk ofinfection due to the exposure of the prepared tooth, whether or not atemporary crown is used.

In accordance with another aspect of the technology, a system for use bya dentist in precisely preparing, revising, or modifying a working toothto be treated for receipt of a restoration, which preferably may bepreformed prior to use of the system and which may be but is not limitedto being an inlay, onlay, crown, bridge, or veneer, is provided. Such asystem may include two main components: (i) at least one dentalinstrument configured for contacting one or more surfaces of a suitableguiding configuration of an overlay device and for contacting toothstructure to remove such tooth structure and (ii) at least one overlaydevice, which may be a dental overlay, that is configured for attachmentto either or both of a working tooth to be treated and an adjacent orneighboring tooth (or adjacent teeth or neighboring teeth) of the toothto be treated and that further includes one or more guiding surfaces tocontact the dental instrument to limit 3D movement of such instrument toa predetermined 3D region of the tooth to be treated from which toothstructure is to be removed. In operation, the overlay device maycoordinate with the dental instrument to limit the 3D movement of thedental instrument with respect to a tooth being treated, when the dentalinstrument appropriately contacts the guiding surface or surfaces of theoverlay device, such that the dental instrument removes tooth structurefrom a predetermined 3D region of the tooth being treated to form aprepared tooth. In this manner, the prepared tooth may be prepared toconform to the configuration of the preformed restoration. The preformedrestoration may then be placed permanently or substantially permanentlyon the prepared tooth.

In some arrangements, the dental instrument may include a cutting tool,which may be but is not limited to being a dental burr, configured forthe removal of the tooth structure to be removed from the working toothto be treated. In a modified version, the system may further include adental placement device, which may be in the form of another overlaydevice, configured for the placement of a restoration. The dentalplacement device may be configured for maintaining the position of therestoration against the tooth (or a corresponding set of teeth) beingtreated during affixation of the restoration to the tooth (or thecorresponding set of teeth). A method of use of such system and themodified system is further provided in accordance with the presenttechnology.

In accordance with another aspect of the technology, dentalinstrumentation for use in guiding a cutting tool to remove toothstructure from a tooth to be treated in the mouth of a patient may beprepared by a process. In this process, a first Boolean operation may beperformed by one or processors between initial cutting guide datacorresponding to a cutting guide shell structure for placement around aportion of the tooth to be treated and cutting tool path datacorresponding to preset limits on tool movements to be made by thecutting tool. The first Boolean operation may define final cutting guidedata corresponding to final cutting guide structure for guiding thecutting tool. In this process, a second Boolean operation may beperformed by the one or more processors between initial instrumentconfiguration data corresponding to a fixation instrument configurationfor fixing the dental instrumentation to an adjacent tooth to the toothto be treated in the mouth of the patient and the final cutting guidedata. The second Boolean operation may define final instrumentconfiguration data corresponding to a final instrument configuration forreleasably fixing the dental instrumentation to the adjacent tooth andfor guiding the cutting tool in the removal of the tooth structure fromthe tooth to be treated.

In some arrangements, a physical model of a plurality of teeth in themouth of the patient may be scanned and original tooth datacorresponding to a digital topography of the scanned physical model ofthe plurality of teeth may be received by the one or more processors.The plurality of teeth may include the tooth to be treated. In some sucharrangements, tooth addition data corresponding to digital void fillersfor filling the digital topography of the scanned physical model of theset of teeth may be stored by the one or more processors and theoriginal tooth data and the tooth addition data may be meshed by the oneor more processors to define new tooth data. In some such arrangements,first cutting path data corresponding to a first cutting path to befollowed by the cutting tool based on the original tooth data or the newtooth data may be stored by the one or more processors, and firstcutting depth data corresponding to a cutting depth to be reached by thecutting tool based on the original tooth data or the new tooth data maybe stored by the one or more processors. The cutting tool path data maybe based on the first cutting depth data and the first cutting pathdata.

In some arrangements, the first cutting depth data may be included inthe first cutting path data. In some arrangements, the first cuttingpath may be curved. In some arrangements, the first cutting path may beplanar.

In some arrangements, first cutting path data corresponding to a firstcutting path to be followed by the cutting tool based on the originaltooth data or the new tooth data may be stored by the one or moreprocessors. In such arrangements, first cutting depth data correspondingto a cutting depth to be reached by the cutting tool based on theoriginal tooth data or the new tooth data may be stored by the one ormore processors. The first cutting path data may be adjusted by the oneor more processors to create second cutting path data corresponding to asecond cutting path adjusted from the first cutting path. In sucharrangements, the second cutting path data may be stored by the one ormore processors in which the cutting tool path data may be based on thefirst cutting depth data and either the first cutting path data or thesecond cutting path data. In some arrangements, the cutting tool pathdata may be determined by the one or more processors based on the firstcutting depth data and the first cutting path data or the second cuttingpath data. In some arrangements, the initial cutting guide data may bedetermining by the one or more processors based on the original toothdata or the new tooth data.

In some arrangements, the initial instrument configuration data may bestored by the one or more processors in which the original tooth datamay define an original tooth digital model, the tooth addition data maydefine a void fill digital model, the new tooth data may define a newtooth digital model, the first cutting path data may define a firstcutting path digital model, the first cutting depth data may define afirst cutting depth digital model, the second cutting path data maydefine a second cutting path digital model, the initial cutting guidedata may define an initial cutting guide digital model, the finalcutting guide data may define a final cutting guide digital model, theinitial instrument configuration data may define an initial instrumentconfiguration digital model, and the final instrument configuration datamay define a final instrument configuration digital model.

In some arrangements, the cutting guide shell structure may be a guidebody outer shell corresponding to a digital guide body outer shell.

In some arrangements, the cutting tool path data may be determined bythe one or more processors based on cutting path data corresponding tomovements of the cutting tool predefined for the removal of the toothstructure from the tooth to be treated.

In some arrangements, the cutting tool may be a dental bur. In some sucharrangements, the final cutting guide structure may correspond to acutting guide of a dental overlay. In some such arrangements, thefixation instrument configuration may correspond to a tooth wrap of thedental overlay.

In some arrangements, the final instrument configuration data may beexported by the one or more processors to a data storage file configuredfor use with a computer-aided manufacturing (CAM) or additivemanufacturing (AM) device.

In some arrangements, the dental instrumentation may be fabricated onthe AM device, based on the data storage file, using an additivemanufacturing process. In some such arrangements, the dentalinstrumentation may be a dental cutting guide.

In accordance with another aspect of the technology, dentalinstrumentation for use in applying a restoration to a tooth to betreated in the mouth of a patient may be prepared by a process. In thisprocess, initial primary support configuration data corresponding to adigital model outline of instrument fixation support structure based onrestored tooth data may be stored by one or more processors. Finalprimary support configuration data corresponding to the instrumentfixation support structure may be stored by the one or more processors.Initial lingual support configuration data corresponding to a digitalmodel outline of instrument lingual support structure based on therestored tooth data may be stored by the one or more processors. Finallingual support configuration data corresponding to the instrumentlingual support structure may be stored by the one or more processors inwhich the instrument lingual support structure may be attached to theinstrument fixation support structure. Initial buccal supportconfiguration data corresponding to a digital model outline ofinstrument buccal support structure based on the restored tooth data maybe stored by the one or more processors. Final buccal supportconfiguration data corresponding to the instrument buccal supportstructure may be stored by the one or more processors in which theinstrument buccal support structure may be attached to the instrumentfixation support structure. Occlusal connector configuration datacorresponding to occlusal surface connectors attached to both theinstrument lingual support structure and the instrument buccal supportstructure may be stored by the one or more processors. The final primarysupport configuration data, the final lingual support configurationdata, the final buccal support configuration data, and the occlusalconnector configuration data may define initial retention splint datacorresponding to a rough retention splint configuration.

In some arrangements, the restored tooth data may correspond to a 3Dmodel of a plurality of existing and restored teeth in the mouth of thepatient including the tooth to be treated and a restoration applied tothe tooth to be treated.

In some arrangements, the initial retention splint data may be separatedby the one or more processors from the restored tooth data to form finalretention splint data corresponding to a final retention splintconfiguration. In some such arrangements, the initial primary supportconfiguration data may define an initial primary support design digitalmodel, the final primary support configuration data may define a finalprimary support design digital model, the initial lingual supportconfiguration data may define an initial lingual support configurationdigital model, the final lingual support configuration data may define afinal lingual support configuration digital model, the initial buccalsupport configuration data may define an initial buccal supportconfiguration digital model, the final buccal support design data maydefine a final buccal support configuration digital model, the occlusalconnector configuration data may define an occlusal connectorconfiguration digital model, the initial retention splint data maydefine a rough retention splint digital model, the restored tooth datamay define a restored tooth digital model, and the final retentionsplint data may define a final retention splint digital model.

In some arrangements, the final retention splint data may be exported bythe one or more processors to a data storage file configured for usewith a CAM or AM device. In some such arrangements, the final retentionsplint configuration may be a tray for placing veneers. In sucharrangements, the tray for placing veneers may be fabricated on the AMdevice, based on the data storage file, using an additive manufacturingprocess.

In some arrangements, lingual connecting support configuration datacorresponding to lingual connecting support structure connecting theinstrument fixation support structure to the instrument lingual supportstructure may be stored by the one or more processors. Buccal connectingsupport configuration data corresponding to buccal connecting supportstructure connecting the instrument fixation support structure to theinstrument buccal support structure may be stored by the one or moreprocessors. In some such arrangements, the lingual connecting supportconfiguration data may be manipulated by the one or more processors inwhich the manipulation of the lingual connecting support configurationdata may correspond to a smoothening of a digital model of the lingualconnecting support structure. The buccal connecting supportconfiguration data may be manipulated by the one or more processors inwhich the manipulation of the buccal connecting support configurationdata may correspond to a smoothening of a digital model of the buccalconnecting support structure. In some such arrangements, the initialretention splint data may be further defined by the lingual connectingsupport configuration data and the buccal connecting supportconfiguration data. In some arrangements, the lingual connecting supportconfiguration data may define a lingual connecting support configurationdigital model, and the buccal connecting support configuration data maydefine a buccal connecting support configuration digital model.

In some arrangements, the initial primary support configuration data maybe manipulated to define the final primary support configuration data inwhich the manipulation of the initial primary support configuration datamay correspond to embossing the outline of the digital model outline ofthe instrument fixation support structure. In such arrangements, theinitial lingual support configuration data may be manipulated to definethe final lingual support configuration data in which the manipulationof the initial lingual support configuration data may correspond toembossing the outline of the digital model outline of the instrumentlingual support structure. In such arrangements, the initial buccalsupport configuration data may be manipulated to define the final buccalsupport configuration data in which the manipulation of the initialbuccal support configuration data may correspond to embossing theoutline of the digital model outline of the instrument buccal supportstructure.

In accordance with another aspect of the technology, a working tooth tobe treated in the mouth of a patient may be treated by a process. Inthis process, a first surface of a guide device may be secured onto oneor more teeth of the patient. A drive shaft of a cutting device may beinserted into an opening of the guide device. A flange of the cuttingdevice may be inserted in a direction perpendicular or otherwisetransverse to a longitudinal axis of the drive shaft into a slot of theguide device in which the slot may be in communication with the openingof the guide device. The slot may have a first dimension within a firstplane perpendicular or otherwise transverse to the longitudinal axis ofthe drive shaft in which the first dimension is taken in or along adirection the flange extends when the flange is inserted into the slotthat is greater than a corresponding second dimension of the openingwithin a second plane parallel to the first plane in which the seconddimension is taken in or along the direction the flange extends when theflange is inserted into the slot. The cutting device may be moved, suchas by being slid, to remove portions of the working tooth in preparing aworking surface of the working tooth in which movement of the cuttingdevice may be limited by the guide device to directions within the firstplane and to a thickness of the slot extending in a directionperpendicular to the first plane. In this manner, the flange of thecutting device may be prevented from being received in the opening dueto its dimensions being larger than otherwise corresponding dimensionsof the opening. The flange of the cutting device may be removed from theslot. The guide device may be removed from the mouth of the patient. Arestoration then may be secured by an adhesive to the working surface ofthe working tooth.

In some arrangements, a retention splint retaining the restoration maybe secured onto opposing distal teeth of the patient's teeth such thatthe restoration is retained against the working surface of the workingtooth when the first surface of the guide device is secured onto one ormore teeth of the patient. In some such arrangements, the restorationmay be any one or any combination of a dental crown, a dental bridge,and a dental veneer. In some arrangements, the dental cutting device mayinclude a dental bur.

In some arrangements, a drive head of the cutting device may be exteriorto the guide device when the flange of the cutting device is fullyinserted into the slot of the guide device.

In another aspect of the technology, a dental instrument may include ahand grip, a drive head, a drive shaft, a cutting tool, and a flange.The drive head may be attached to the hand grip. The drive shaft mayextend from the drive head. The cutting tool may be attached to thedrive shaft and may extend along a longitudinal axis of the drive shaft.The flange may extend around the drive shaft and may be spaced from thedrive head. The flange may have length and width dimensions along axesperpendicular to the longitudinal axis of the drive shaft and may have athickness dimension along an axis parallel to the longitudinal axis ofthe draft shaft in which either or both of the length and the widthdimensions of the flange may be greater than the thickness dimension ofthe flange.

In another aspect of the technology, a dental overlay device forlimiting the operation of a dental instrument to a removal of apredetermined portion of the structure of a tooth to be treated in themouth of a patient may include a body having a length, a width, and athickness. The body may include a first surface, a second surfaceopposite the first surface, a first opening, a second opening, and aslot. One or more distances between the first surface and the secondsurface may define the thickness of the body. The first surface may becomplementary to and configured for contacting portions of one or moreteeth in the mouth of the patient to secure the body in a suitableposition with respect to the tooth to be treated. The first opening mayextend through the first surface and may be configured for exposingportions of the tooth structure to be removed from the tooth to betreated. The second opening may be opposite the first opening and mayextend through the second surface in which the second opening may beconfigured for receiving a shaft of a dental instrument through theopening. The slot may be in communication with the second opening andmay be configured for receiving a flange extending from the shaft in adirection perpendicular or otherwise transverse to a longitudinal axisof the shaft. The slot may have a first dimension taken in or along afirst direction, in which the first dimension is within a first planegenerally parallel to the length and the width of the body, that isgreater than a corresponding second dimension of the second openingtaken in or along the first direction, in which the second dimension iswithin a second plane parallel to the first plane. In this manner, whenthe shaft of the dental instrument is received through the secondopening and the flange is received in the slot, movement of the flangemay be limited by the slot. The second opening may define a first sideopening through the thickness on an end of the slot for receiving theshaft of the dental instrument within and in a direction along a planeparallel to the first plane. The slot may define a second side openingthrough the thickness on an end of the slot for receiving the flangewithin and in a direction along the first plane.

In accordance with another aspect of the technology, a dental system forremoving a predetermined portion of the structure of a tooth to betreated in the mouth of a patient may include a dental instrument and adental overlay device for limiting the operation of a dental instrumentto a removal of the predetermined portion of the structure of the toothto be treated. The dental overlay device may include a body having alength, a width, and a thickness. The body may include a first surface,a second surface opposite the first surface, a first opening, a secondopening, and a slot. One or more distances between the first surface andthe second surface may define the thickness of the body. The firstsurface may be complementary to and configured for contacting portionsof one or more teeth in the mouth of the patient to secure the body in asuitable position with respect to the tooth to be treated. The firstopening may extend through the first surface and may be configured forexposing portions of the tooth structure to be removed from the tooth tobe treated. The second opening may be opposite the first opening and mayextend through the second surface in which the second opening may beconfigured for receiving a shaft of a dental instrument through theopening. The slot may be in communication with the second opening andmay be configured for receiving a flange extending from the shaft in adirection perpendicular or otherwise transverse to a longitudinal axisof the shaft. The slot may have a first dimension taken in or along afirst direction, in which the first dimension is within a first planegenerally parallel to the length and the width of the body, that isgreater than a corresponding second dimension of the second openingtaken in or along the first direction, in which the second dimension iswithin a second plane parallel to the first plane. In this manner, whenthe shaft of the dental instrument is received through the secondopening and the flange is received in the slot, movement of the flangemay be limited by the slot. The second opening may define a first sideopening through the thickness on an end of the slot for receiving theshaft of the dental instrument within and in a direction along a planeparallel to the first plane. The slot may define a second side openingthrough the thickness on an end of the slot for receiving the flangewithin and in a direction along the first plane. The dental instrumentmay include a hand grip, a drive head, a drive shaft, a cutting tool,and a flange. The drive head may be attached to the hand grip. The driveshaft may extend from the drive head. The cutting tool may be attachedto the drive shaft and may extend along a longitudinal axis of the driveshaft. The flange may extend around the drive shaft and may be spacedfrom the drive head. The flange may have length and width dimensionsalong axes perpendicular to the longitudinal axis of the drive shaft anda thickness dimension along an axis parallel to the longitudinal axis ofthe draft shaft in which either or both of the length and the widthdimensions of the flange are greater than the thickness dimension of theflange. The drive shaft may be receivable through the first side openingof the second opening, and the flange may be receivable through thesecond side opening. When the flange of the dental instrument isreceived within the slot, movement of the flange in directions withinthe first plane and in a direction perpendicular to the first plane maybe limited by the slot.

In accordance with an aspect of the technology, a dental overlay systemfor the placement of one or more veneers into the mouth of a patient mayinclude one or more veneers and a dental overlay device. The dentaloverlay device may include a curved body. A body surface on the curvedbody may be complementary to and configured for contacting portions ofone or more teeth in the mouth of a patient, including distal teeth onopposite sides of the patient's mouth, to secure the body in a suitableposition on the patient's teeth. The one or more veneers may betemporarily attached to the body surface. A plurality of holes mayextend through the curved body and may correspond to locations on aplurality of teeth.

In some arrangements, the body surface may include first and secondportions that may be configured for contacting molars on opposite sidesof the patient's mouth. The first and second portions of the bodysurface may be solid such that no holes extend through these portions.

In some arrangements, the curved body may define individual tooth formseach having an outline of a portion of a tooth of the teeth in thepatient's mouth and through which the holes of the plurality of holesextend. In such arrangements, a maximum of two holes may extend througheach individual tooth form of the curved body. In some sucharrangements, one or more of the individual tooth forms of the curvedbody do not have any holes that extend through such tooth forms.

In some arrangements, the dental overlay device may include a minimum of16 holes through the curved body for use with the placement of ten (10)veneers corresponding to a full dental arch. In some arrangements, thedental overlay device may include a maximum of 20 holes through thecurved body for use with the placement of ten (10) veneers correspondingto a full dental arch. In some such arrangements, the dental overlaydevice may include a minimum of 16 holes through the curved body.

In some arrangements, the curved body may define individual tooth formseach having an outline of a portion of a tooth of the teeth in thepatient's mouth and through which the holes of the plurality of holesextend. In such arrangements, a minimum of three holes may extendthrough each individual tooth form of the curved body for each toothform through which a hole of the plurality of holes extend. In some sucharrangements, a maximum of six holes may extend through each individualtooth form of the curved body.

In some arrangements, the dental overlay device may include a minimum of30 holes through the curved body for use with the placement of ten (10)veneers corresponding to a full dental arch. In some arrangements, thedental overlay device may include a maximum of 60 holes through thecurved body for use with the placement of ten (10) veneers correspondingto a full dental arch. In some such arrangements, the dental overlaydevice may include a minimum of 30 holes through the curved body.

In some arrangements, at least some of the plurality of holes may have adiameter in the range of approximately 1.5 mm to approximately 4 mm.

BRIEF DESCRIPTION OF THE DRAWINGS

A more complete appreciation of the subject matter of the presenttechnology and the various advantages thereof may be realized byreference to the following detailed description which refers to theaccompanying drawings, in which:

FIG. 1 is a functional diagram in accordance with an embodiment;

FIG. 2 is an elevation view of a computer-aided drawing (CAD) model of ascanned physical 3D model of teeth;

FIG. 3 is a plan view of the CAD model of FIG. 2 following thecorrection of errors in the model in accordance with an embodiment;

FIG. 4A is a plan view of the CAD model of FIG. 3 following remeshing ofthe CAD model;

FIG. 4B is a plan view of the CAD model of FIG. 4A after refreshing ofthe CAD model;

FIG. 5 is a plan view of the CAD model of FIG. 4B after importation intoa solid model building application in accordance with an embodiment;

FIG. 6 is a partial plan view of the CAD model of FIG. 5 with theaddition of a working plane marker to the model;

FIG. 7 is a partial perspective view of the CAD model of FIG. 5 with theaddition of tool markers to the model;

FIG. 8 is a partial perspective view of a modified version of the CADmodel of FIG. 5 modeling prepared working teeth and the addition of atool path marker to the model;

FIG. 9 is a partial perspective view of the CAD model of FIG. 5 in whichthe tool path marker shown in FIG. 8 has been adjusted;

FIG. 10 is a partial perspective view of a modified version of the CADmodel of FIG. 5 highlighting cuts to modeled prepare working teeth forvalidation by a user;

FIG. 11 is a partial perspective view of a modified version of the CADmodel of FIG. 5 with the addition of an in-process digital guide bodyouter shell in accordance with an embodiment;

FIG. 12 is a partial perspective view of the CAD model of FIG. 11 withthe addition of a digital cutting tool surrogate to the digital guidebody outer shell;

FIG. 13 is a perspective view of the CAD model of FIG. 5 with theaddition of boundary markers in accordance with an embodiment;

FIG. 14 is a perspective view of a CAD model of a digital tooth wrap inaccordance with an embodiment;

FIG. 15 is a perspective view of a CAD model of an in-process digitalguide device in accordance with an embodiment;

FIG. 16 is a perspective view of a CAD model of a digital guide deviceprepared with the in-process digital guide device of FIG. 15 beingcompared with the teeth of the CAD model of FIG. 5 in accordance with anembodiment;

FIG. 17 is a perspective view of a physical guide device in accordancewith an embodiment;

FIG. 18 is a perspective view of a physical guide device in accordancewith an embodiment;

FIGS. 19A and 19B are perspective views of the inside of the mouth ofpatient prior to and after preparation of the patient's teeth,respectively, in accordance with an embodiment;

FIG. 20 is a process flow diagram of a process for preparing the teethof a patient to receive a restoration in accordance with an embodiment;

FIG. 21 is a plan view of a graphical user interface (GUI) during theimportation of CAD models of the teeth of a patient including preparedworking teeth and of a restoration into the specialty tool package toform a digital restored 3D model in accordance with an embodiment;

FIG. 22 is a plan view of the CAD models of the teeth of the patient andof the restoration imported using the graphical user interface shown inFIG. 21;

FIGS. 23A and 23B are elevation and plan views, respectively, ofmodified CAD models of the digital restored 3D model of FIG. 22 inaccordance with an embodiment;

FIGS. 24A-24C show process steps during the transformation of themodified CAD model of FIGS. 23A and 23B from a digital clay model to arestored 3D buck model in accordance with an embodiment;

FIGS. 25A and 25B are perspective and plan views, respectively, of therestored 3D model of FIGS. 24B and 24C along with the addition of aboundary line for a digital primary support in accordance with anembodiment;

FIG. 26 is a plan view of the restored 3D model of FIG. 25B with theaddition of a boundary line for a digital lingual auxiliary support inaccordance with an embodiment;

FIGS. 27A and 27B show process steps for embossing digital support teethto form the digital primary support of an in-process digital placementtray in accordance with an embodiment;

FIG. 28 shows a process step for embossing a digital lingual side ofdigital working teeth to form the digital lingual auxiliary support ontothe in-process digital placement tray of FIG. 27B in accordance with anembodiment;

FIG. 29 shows a process step for forming a digital intersection of thein-process digital placement tray of FIG. 28 between the digital primarysupport and the digital lingual auxiliary support in accordance with anembodiment;

FIG. 30 shows process step for smoothening the digital intersection ofthe in-process digital placement tray prepared by the processillustrated in FIG. 29 and portions of the digital primary support andthe digital lingual auxiliary support around the digital intersection inaccordance with an embodiment;

FIGS. 31A and 31B show elevation views of the in-process digitalplacement tray of FIG. 30 along with the addition of a boundary line fora digital buccal auxiliary support in accordance with an embodiment;

FIG. 32 shows the in-process digital placement tray of FIG. 31B with theaddition of embossing to the digital buccal side of digital workingteeth to form a digital buccal auxiliary support onto the in-processdigital placement tray;

FIG. 33A is a partial elevation view of a digital intersection addedonto the in-process digital placement tray of FIG. 32 between thedigital primary support and the digital buccal auxiliary support inaccordance with an embodiment;

FIG. 33B is a plan view of the digital primary support, digital buccalauxiliary support, and the digital intersection therebetween of thein-process digital placement tray of FIG. 33A after being smoothened inaccordance with an embodiment;

FIGS. 34A and 34B are plan and elevation views, respectively, of thein-process digital placement tray of FIG. 33B with the addition ofdigital connector supports in accordance with an embodiment;

FIG. 35 shows a process step for diving the in-process digital placementtray of FIGS. 34A and 34B from the restored 3D buck model of FIGS. 24Band 24C in accordance with an embodiment;

FIG. 36 shows a process step for cleaning the in-process digitalplacement tray shown in FIG. 35 in accordance with an embodiment;

FIG. 37 is a plan view of the final digital placement tray after thecleaning step shown in FIG. 36 in accordance with an embodiment;

FIG. 38 shows a step of manipulating the data associated with the finaldigital placement tray of FIG. 37 to form a data file for use with afabrication device in accordance with an embodiment;

FIG. 39 shows an additive manufacturing machine that may be used to forma physical placement tray corresponding to the final digital placementtray of FIG. 37 in accordance with an embodiment;

FIGS. 40A-40C are perspective views of physical placement trays inaccordance with various embodiments;

FIG. 41 is a perspective view of a physical placement tray system inpreparation for the application of veneers to the teeth of a patient inaccordance with an embodiment;

FIGS. 42A and 42B are perspective views of physical placement traysystem of FIG. 41 being applied to the teeth of a patient and followingapplication to the teeth of the patient, respectively, in accordancewith an embodiment;

FIGS. 43A and 43B are perspective views of the teeth of a patient beforeand after placement of the veneers of the physical placement tray systemof FIG. 41; and

FIG. 44 is a process flow diagram of a process for preparing a placementand retention device for applying a restoration to the teeth of apatient in accordance with an embodiment.

DETAILED DESCRIPTION

Where reference is made herein to a method comprising two or moredefined steps, the defined steps can be carried out in any order orsimultaneously (except where the context excludes that possibility), andthe method can include one or more other steps which are carried outbefore any of the defined steps, between two of the defined steps, orafter all the defined steps (except where the context excludes thatpossibility).

The terms “lower,” “upper,” “top,” “bottom,” and variations of suchterms as well as derived directional terms such as “horizontal,”“vertical,” “upward,” and “downward” are based on a normal configurationof an overlay as shown in the drawings, in which the overlay is fittedonto the lower teeth of a patient with the roots of the teeth extendingvertically downward. The term “dentist” in this text is not to beinterpreted restrictively and can also be read as dental practitioner,dental technician, dental assistant, dental hygienist, dental auxiliary,dental therapist, dental designer, etc.

According to conventional techniques, a diagnostic evaluation of a toothreveals an existing condition requiring a tooth to be treated by theinstallation of a restoration or prosthesis. Under these conventionalapproaches, the tooth to be treated is revised and prepared first, andthen its revised configuration is used to fabricate the internalconfiguration of the restoration. Therefore, the restoration isfabricated to fit the already prepared tooth.

In accordance with an embodiment of the present technology, as with suchconventional approaches, a dentist may identify by either or both ofx-ray and other diagnostic techniques portions of an existing workingtooth of a patient that should be removed, due to e.g., decay, cracks,weaknesses, dislocations, deformities, impediments to bite, or othermaladies or undesirable aspects of the tooth. In some arrangements, thedentist may then prepare a physical 3D model, which preferably may beany one or a combination of a cast, a mold, and an impression, of theentire lower or entire upper set of teeth in the patient's mouth thatinclude the working tooth and a neighboring tooth or neighboring teethof the working tooth, although in some instances the physical 3D modelmay only include a portion of the lower or the upper set of teeth as thecase may be.

Referring now to the drawings, the prepared physical 3D model then maybe digitally scanned with a scanning device by the dentist, such as withbut not limited to being with a handheld 3D scanner or other scanningdevices such as those by Imetric 3D providing photogrammetry andstructured light scanning, to create original tooth data 125 to bestored in memory 124 of first client computer 120, as referenced in FIG.1, corresponding to a scanned topography of the physical 3D modelincluding a model of the working tooth to be treated. In some otherarrangements, the dentist may directly scan, e.g., with a handheld 3Dscanner, all or a portion of the lower or upper set of teeth includingthe working tooth in the patient's mouth to create original tooth data125. Alternatively, the dentist may send the physical 3D model to athird party, which preferably may be, or may work in conjunction with, asecond user of second client computer 130 described further herein andfurther referenced in FIG. 1, who or which may digitally scan thephysical 3D model prepared by the dentist to create original tooth data125.

A system for preparing instrumentation to assist in the preparation ofone or more working teeth to receive a restoration, for the actualpreparation of the one or more working teeth to receive the restoration,for preparing the restoration, and for placing the restoration isprovided.

As further shown in FIG. 1, system 105 may be used, among otherfunctions, to generate, store and share data corresponding tothree-dimensional models of structures, such as but not limited toteeth. System 105 may include at least one server computer 110, firstclient computer 120, and at least second client computer 130 which maybe located remotely from the first client computer. Each of thesecomputers may send and receive information via network 140.

Network 140, and intervening communication points, may include variousconfigurations and protocols including the Internet, World Wide Web,intranets, virtual private networks, wide area networks, local networks,private networks using communication protocols proprietary to one ormore companies, Ethernet, WiFi and HTTP, and various combinations of theforegoing. Communications among these configurations and applying theseprotocols may be facilitated by any device configured for transmittingdata to and from other computers, such as modems (e.g., dial-up, cable,or fiber optic) and wireless interfaces. Although FIG. 1 illustratesonly a few devices, system 105 may include a large number of connectedcomputers, with each different computer being at a differentcommunication point of the network.

Computers 110, 120, 130 each may include a processor and memory. Forexample, server 110 may include memory 114 which stores informationaccessible by processor 112, first client computer 120 may includememory 124 which stores information accessible by processor 122, andsecond client computer 130 may include memory 134 which storesinformation accessible by processor 132. Each of processors 112, 122,132 may be any conventional processor, such as commercially availablecentral processing units (CPUs). Alternatively, any of processors 112,122, 132 may be dedicated controllers such as an ASIC, FPGA, or anotherhardware-based processor. Although shown in FIG. 1 as being within thesame block, each processor and its corresponding memory may actuallycomprise multiple processors and memories that may or may not be storedwithin the same physical housing. For example, memories may be a harddrive or other storage media located in a server farm of a network datacenter. Accordingly, references to a processor, memory, or computer willbe understood to include references to a collection of processors,memories, or computers that may or may not operate in parallel.

Each of memories 114, 124, 134 may include first part storingapplications or instructions 116, 126, 136 that may be executed by therespective processor. Instructions 116, 126, 136 may be any set ofinstructions to be executed directly (such as machine code) orindirectly (such as scripts) by the processor. In that regard, the terms“applications,” “instructions,” and “programs” may be usedinterchangeably herein. The memories may also include second partstoring data 118, 128, 138 that may be retrieved, stored or modified inaccordance with the respective instructions. The memory may include anytype configured for storing information accessible by the processor,such as a hard-drive, memory card, ROM, RAM, DVD, CD-ROM, write-capable,and read-only memories or various combinations of the foregoing, whereinstructions or applications 116, 126, 136 and corresponding data 118,128, 138 are stored on the same or different types of media.

For example, the dentist or the referenced third party may storeoriginal tooth data 125 of data 128, once generated, within memory 124of first client computer 120. Generated original tooth data 125 may thenbe uploaded to server 110 and distributed via network 140 to secondclient computer 130. Alternatively, when the third party is or works inconjunction with the second user of second client computer 130, originaltooth data 125 may be received by second client computer 130 directlyfrom the scanning device used to scan the topography of the lower orupper set of teeth of the patient or of the physical 3D model of suchteeth (hereinafter referred to as the “scanned tooth topography”), asthe case may be.

In addition to a processor, memory and instructions, client computers120, 130 may have all of the components used in connection with apersonal computer. For example, the client computers may includeelectronic display 127, 137 (e.g., a monitor having a screen, atouch-screen, a projector, a television, a computer printer or any otherelectrical device that is operable to display information including butnot limited to a smartphone or other similar handheld device), one ormore user inputs (e.g., a mouse, keyboard, touch screen and/ormicrophone), one or more sound outputs such as speakers, and all of thecomponents used for connecting these elements to one another.

As further shown in FIG. 1, at least instructions 136 of second clientcomputer 130 may include building application 135, or alternativelysolid model building application 135A. The building application may becomputer-aided design (CAD) 3-D modeling software or equivalent as knownin the art, which preferably may be but is not limited to being GEOMAGICFREEFORM by 3D Systems, Inc. or SOLIDWORKS® by SolidWorks Corporationbut may also be other similar software programs such as but not limitedto Autodesk® AutoCAD®, Creo® by Parametric Technology Corporation(formerly Pro/Engineer), Siemens PLM Software NX™ (formerly UnigraphicsNX), and CATIA® by Dassault Systemes. After receiving original toothdata 125, building application 135 may execute instructions, among otherinstructions it may execute, to convert the original tooth data intodigital 3D model 139 which may be a wireframe structure in the form ofthe scanned topography of either or both of a lower and an upper set ofteeth of the patient (which may be a scanned topography of the physical3D model) including the working tooth to be treated. In this manner, 3Dmodel 139 may be viewable on electronic display 137, such as within agraphical user interface (GUI) of building application 135, andmodifiable with a user input by a second user, who or which may be thefirst user or a different user from the first user, using buildingapplication 135.

In some arrangements, instructions 126 of first client computer 120 mayalso include a building application, and in some such arrangements, thisbuilding application may be the same as building application 135. Inthis manner, in such arrangements, first client computer 120 may convertoriginal tooth data 125 into digital 3D model 139 for viewing orpossible modification of the model before uploading the original toothdata or a modified version of the original tooth data to server 110.Either or both of building application 135 of second client computer 130and any building application stored in memory 124 of first clientcomputer 120 further may be associated with a GUI for displaying digital3D model 139 on a client device in order to allow the user to utilizethe functions of the building applications.

Data 118, 128, 138 need not be limited by any particular data structure.For example, the data may be stored in computer registers, in arelational database as a table having a plurality of different fieldsand records, or XML documents. The data also may be formatted into anycomputer-readable format such as, but not limited to, binary values,ASCII or Unicode. Moreover, the data may comprise any informationsufficient to identify the relevant information, such as numbers,descriptive text, proprietary codes, pointers, references to data storedin other memories (including other network locations) or informationthat is used by a function to calculate the relevant data. For example,data 138 of second client computer 130 may include information used bybuilding application 135 to create 3D model 139.

In addition to the operations described above and illustrated in thefigures, various other operations will now be described. It should beunderstood that the following operations do not have to be performed inthe precise order described below. Rather, various steps may be handledin a different order or simultaneously. Steps also may be omitted oradded unless otherwise stated herein.

PART 1: Digital Preparation of Preparation Guide Devices for Preparing aWorking Tooth to be Treated

Referring now to FIGS. 2-16, building application 135 is retrofittedwith a specialty tool package that allows digital preparation ofcomputer-generated models of tooth structure and correspondingpreparation guide devices, which may be configured to fit and cooperatewith a custom handpiece. In the example shown, building application 135is GEOMAGIC FREEFORM by 3D Systems, Inc.

As shown in FIG. 2, original digital 3D model 139 is imported byprocessor 132 into the specialty tool package. Excess regions of thedigital 3D model that are unneeded for preparing the preparation guidedevices may then be trimmed from the 3D model, as in the example shown,eliminating excessive data that may slow down the CAD software.

As shown in FIG. 3, the user, e.g., the second user, of buildingapplication 135 may then use the specialty tool package to check digital3D model 139, or such model after trimming, for suspected errors in the3D model that may be but are not limited to being caused by any one orany combination of a poor resolution of the scanned tooth topographywhether directly from the patient's mouth or from a 3D physical model, apoor resolution of the 3D physical model of the tooth to be treated, andvoids or extraneous projections in the physical model. As shown, 3Dmodel additional structure 145 corresponding to tooth addition data maybe identified for addition to any undesired voids identified in originaldigital 3D model 139, and any undesired projections identified in thedigital 3D model are selected for removal from the original digital 3Dmodel. The audit check and identification of needed error correctionsmay be performed by the processor using building application 135. Theuser of building application 135 may then provide an input, such as byclicking an icon on a GUI of the building application to accept theadditional structure 145 and as well as the removal of undesiredprojections. As shown in FIGS. 4A and 4B, original 3D model 139 may beremeshed into a single mesh, including meshing with 3D model additionalstructure 145, and refreshed to form new remeshed digital 3D model 139A′and new (refreshed) digital 3D model 139A corresponding to new toothdata 125A. In preferred alternative arrangements, errors in originaldigital 3D model 139 may be automatically repaired upon importing theoriginal digital 3D model into the specialty tool package of buildingapplication 135, as well as after subsequent trimming of the originaldigital 3D model to form new digital 3D model 139A. As shown in FIG. 5,new digital 3D model 139A is imported into a specialty tool package of asolid model building application 135A.

As shown in FIG. 6, working plane 147 is set at an appropriate positionand orientation relative to the digital model of the working tooth to betreated, i.e., digital working tooth 150. As in this example, workingplane 147 preferably may be positioned generally parallel to a sectionof digital working tooth 150 (in the example shown, working teeth 150 tobe treated) that will become the prepared surface of the working toothafter preparation of the working tooth. In this example, working plane147 is perpendicular to an axis defining apical-coronal directions,while in other arrangements, the working plane may be set at otherorientations such as but not limited to along a mesial-distal axis. Theorientation of working plane 147 sets the orientation of other settingsdescribed further herein.

As shown in FIG. 7, a depth for what will become the prepared surface ofthe working tooth to be treated is set by depth markers 149A, 149Bwithin solid digital 3D model 139B. When the existing original surfaceof the working tooth to be treated is prepared by a cutting tool, e.g.,a dental bur, a saw, a high pressure fluid jet cutter, etc., asdescribed further herein, the depth set by depth marker 149A correspondsto a current setting for the depth that a tip or edge of the cuttingtool will reach during preparation of the working tooth, and the depthset by depth marker 149B corresponds to a desired depth that the tip orthe edge of the cutting tool reaches during preparation of the workingtooth. Tool surrogate 148 extends in a direction of the tip of thecutting tool, e.g., a bur, intended for the preparation of the workingtooth.

As shown in FIG. 8, tool path 151 is initially set within solid modelbuilding application 135A as cutting path data at a position spaced fromdigital working tooth 150 along a path to be followed by the cuttingtool. Path 151 is preferably one that removes the minimal amount oftooth structure from the working tooth to be treated that is needed tobe removed to correct for each malady or other undesirable aspect of theworking tooth while also providing a sufficient surface area andappropriate form to attach a restoration. Additionally, although path151 may be in any form within the limitations of solid model buildingapplication 135A and the cutting tool, the path is preferably in theform of a plane or a curvate shape that may be convex or concaverelative to digital working tooth 150. Tool path 151 is preferably setafter the depth is set by depth markers 149A, 149B, although the pathmay be set before or even simultaneously with the depth setting as well.As further shown by FIG. 8, while setting tool path 151 and depthmarkers 149A, 149B, digital working tooth 150 may be displayed withdigital cuts corresponding to the currently planned cuts to be made tothe working tooth.

Referring to FIG. 9, with tool path 151 initially set, the tool path maybe moved closer or further away from the working tooth to be treated.Tool path 151 may also be moved generally parallel to an outer surfaceof digital working tooth 150, e.g. in a labial or lingual direction. Asshown in FIG. 10, with tool path 151 set at a proposed position andorientation, digital prepared surface 155 of digital working tooth 150corresponding to tool path 151 may be highlighted along edge 155A toaccentuate the curvature of the digitally prepared surface correspondingto a proposed prepared surface of the patient upon removal of toothstructure from the working tooth to be treated. In this manner, the userof solid model building application 135A may validate the location oftool path 151 to confirm it is at the desired location and to generateprepared 3D model 139C including digital working tooth 150 with digitalprepared surface 155. Otherwise, tool path 151 may be any one or anycombination of repositioned and reoriented relative to digital workingtooth 150 until the tool path is positioned to achieve the desired toothpreparation. The user of solid model building application 135A thenprovides an input, such as by clicking an icon on the GUI of thespecialty tool package, to set the tool path upon which cutting toolpath data, which corresponds to digital cutting tool surrogate 164 shownin FIG. 12 and discussed further below, is determined by the buildingapplication and stored in an object list. As in the example shown inFIG. 12, the cutting tool path data may correspond to slots to be formedin digital guide body 165 discussed further below.

Referring now to FIG. 11, once tool path 151 is determined and set wheredesired, the user of solid model building application 135A provides aninput, such as by clicking an icon on the GUI of the specialty toolpackage, to instruct the building application to create initial cuttingguide data corresponding to digital guide body outer shell 162 aroundouter surface 153 of digital working tooth 150 (See FIGS. 7 and 9). Asin the example shown, solid model building application 135A ispreferably configured with preset outer dimensions defined by digitalshell outer surface 163 of digital guide body outer shell 162, which maybe based on population sample data of the configuration of patients'mouths, that are applied to the digital guide body outer shell whenformed, although such dimensions may be modified within solid modelbuilding application 135A, e.g., to address extreme variations of theconfiguration of the particular patient's mouth from the standarddimensions preset in the building application. As in the example shown,digital guide body outer shell 162 may also extend around digital outersurface 154 of digital neighboring tooth 152 (or digital outer surfaces154 of digital neighboring teeth 152 as shown) of digital working tooth150 that corresponds to the neighboring tooth of the working tooth ofthe patient to be treated. In this manner, a portion of digital guidebody outer shell 162 may conform to digital outer surface 154 of digitalneighboring tooth 152.

As illustrated by FIG. 12, the user of solid model building application135A provides an input, such as by clicking an icon on the GUI of thespecialty tool package, to instruct the building application to displaydigital cutting tool surrogate 164 within digital guide body outer shell162 based on the cutting path data described above. Digital cutting toolsurrogate 164 has dimensions at its extremities that correspond to theextremities of possible travel of extremities of a physical cuttingtool, such as those described previously herein. The user of solid modelbuilding application 135A then provides an input, such as by clicking anicon on the GUI of the specialty tool package, to instruct the buildingapplication to apply a Boolean operation to merge digital guide bodyouter shell 162 and digital cutting tool surrogate 164 at theirintersections. The model created by this merger corresponds to finalcutting guide data. This Boolean operation is a subtractive operationsuch that the volume and shape of digital cutting tool surrogate 164 issubtracted from digital guide body outer shell 162 to form digital guidebody 165.

Referring now to FIG. 13, a user of a building application, which may bebuilding application 135, provides an input, such as by clicking an iconon a GUI of the specialty tool package used in preparing new digital 3Dmodel 139A, of another specialty tool package, or otherwise in thebuilding application, to place boundary markers 166 at the base of thedigital crown of digital neighboring tooth 152 (or, as in the exampleshown, a plurality of neighboring teeth 152) of digital working tooth150 and of digital working tooth 150. Boundary markers 166 establish adesired depth along a tooth wrap to be generated based on digital toothwrap 168 shown in FIG. 14. Still referring to FIG. 14, the user ofbuilding application 135 provides an input, such as by clicking an iconon the GUI of the specialty tool package or otherwise in the buildingapplication, to instruct the building application to create initialinstrument configuration data corresponding to digital tooth wrap 168having digital inner surfaces (not shown) identical to or substantiallyidentical to, i.e., having dimensions slightly offset from, digitalouter surfaces 154 of respective digital neighboring teeth 152 as wellas with bottom surfaces intersecting boundary markers 166. In thismanner, the digital inner surfaces of digital tooth wrap 168 may conformto digital outer surfaces 154 of digital neighboring teeth 152. As inthe example shown, building application 135 is preferably configured toform digital wrap outer surfaces 169 of digital tooth wrap 168 byproviding one or more preset offsets to the digital inner surfaces, inwhich such offsets may be but are not limited to being based onpopulation sample data of the configuration of patients' mouths, thatare applied to digital tooth wrap 168 when formed, although suchdimensions may be modified within building application 135, e.g., toaddress extreme variations of the configuration of the particularpatient's mouth from the standard offsets in the building application.

As shown in FIG. 15, digital tooth wrap 168 is imported from buildingapplication 135 into solid model building application 135A, and the userof building application 135 then provides an input, such as by clickingan icon on the GUI of a specialty tool package within solid modelbuilding application 135A, to instruct solid model building application135A to apply a Boolean operation to merge digital tooth wrap 168 withmerged digital guide body 165 to form digital guide device 170.

Referring now to FIG. 16, the user of building application 135A mayprovide an input, such as by clicking an icon on the GUI of thespecialty tool package, to place digital guide device 170 onto newdigital 3D model 139B to confirm the fit of the digital guide device.The finalized configuration of the digital guide device 170 correspondsto and may be stored in second client computer 130 as final instrumentconfiguration data. Once the user is satisfied with the configuration ofdigital guide device 170, the user of building application 135 mayprovide an input, such as by clicking an icon on the GUI of thespecialty tool package, to export digital guide device 170, which may beexported as a new file such as but not limited to an .STL file, to anappropriate computer-aided manufacturing (CAM) device, which may be anyknown appropriate subtractive manufacturing device that removes materialfrom a block of material or any known appropriate additive (layer)manufacturing (AM) device, such as a stereolithography machine, thatwould build a guide device having the dimensions corresponding to thedimensions set for digital guide device 170. Physical guide devicespreferably may be made of plastics such as but not limited to VisiJetM2R-TN (Dental), VisiJet M3 Crystal (MJP), VisiJet M3 Dentcast (MJP),VisiJet M3 Pearlstone (MJP), VisiJet M3 Stoneplast (MJP), VisiJet SLe-Stone (SLA), NextDent Ortho IBT, NextDent Ortho Clear, and NextDentModel Ortho, all by 3D Systems, Inc.

As further shown in FIG. 16, digital guide body 165 of digital guidedevice 170 generally includes digital entry portion 172 and digitalslide portion 177. Digital entry portion 172 includes digital cuttingtool passage 173, shown in FIG. 16, (having a first height 195 and afirst width 201, represented in dashed lines) corresponding to physicalcutting tool passage 183, shown in FIG. 18, (having a first height 198and a first width 202, represented in dashed lines) of physical guidebody 181 configured to receive a shaft of a cutting tool, e.g., thecutting edges of shaft 211 of dental bur 210, and digital guide entryslot 174, shown in FIG. 16, (having a second height 196 and a secondwidth 191, represented in dashed lines) corresponding to physical guideentry slot 184, shown in FIG. 18, (having a second height 199 and asecond width 193, represented in dashed lines) of physical guide body181 configured to receive a corresponding mechanical guide of thecutting tool, e.g., guide plate 212 on dental bur 210 (see FIG. 18).Digital slide portion 177 includes digital connector opening 178corresponding to a physical connector opening of physical guide body 181configured to receive a connector of the cutting tool, e.g., connector214 of dental bur 210, and allow the connector to slide within theopening as well as digital guide slide slot 175 corresponding to aphysical guide slide slot of physical guide body 181 configured toreceive the corresponding mechanical guide of the cutting tool.Connecting digital entry portion 172 and digital slide portion 177 isdigital bridge opening 179, shown in FIG. 16, (having a third height 197and a third width 192, represented in dashed lines) corresponding tophysical bridge opening 189, shown in FIG. 18 (having a third height 200and a third width 194, represented in dashed lines) of physical guidebody 181 which, like the connector opening, is configured to receiveconnector 214 of the cutting tool (see FIG. 18).

Examples of physical guide devices having entry and slide portionsfabricated from corresponding digital guide devices having correspondingdigital entry and digital slide portions are shown in FIGS. 17 and 18 intheir appropriate positions on working teeth within the mouth of apatient. In the example of FIG. 17, physical guide device 180A, whichhas been fabricated in the manner set forth above, includes a series ofthree physical guide bodies 181A, 181B, 181C attached togetherend-to-end and physical tooth wrap 188A attached to an end of one of theguide bodies. In the example of FIG. 18, dental preparation system 100includes physical guide device 180B and dental instrument 210, which maybe a cutting tool in the form of a dental bur in this example, insertedinto the physical guide device. As shown, physical connector 214connects handpiece 215, which includes a motor for rotation of shaft211, of dental instrument 210 to guide plate 212 of the dentalinstrument. In this manner, a sufficient force exerted on handpiece 215in a direction parallel to a longitudinal axis of physical guide entryslot 184 of physical guide body 181 and in a direction perpendicular toentry opening 184A, which force may be caused by a dentist holding thehandpiece, moves dental instrument 210 until guide plate 212 of thedental instrument abuts the physical guide slide slot of physical guidebody 181. Once guide plate 212 is so positioned in abutment with thephysical guide slide slot, guide plate 212 may be slid between ends ofthe physical guide slide slot corresponding to opposing digital guideslide slot ends 175A (see FIG. 16; one end of digital guide slide slotnow shown).

Preferably, during treatment of the working tooth to be treated, thephysical guide device of the present technology, such as physical guidedevices 180A, 180B, should remain fixed and not move once it is placedaround the working tooth. Moreover, the physical guide device shouldremain in a stable position even when a dental instrument intended foruse with the dental instrument, such as dental instrument 210, makescontact with it. The position of the physical guide device can besecured by contact of surfaces of the physical guide device withsurfaces of teeth in a patient's mouth, preferably around the crowns ofthe patient's teeth, or by the use of a bonding agent, such as one thatis light cured or a temporary cement or by projections from the physicalguide device that engage portions of one or more teeth in the patient'smouth, including the working tooth, any adjacent teeth of the workingtooth such as the neighboring teeth of the working tooth, or dentitionon the jaw opposing the jaw with the working tooth.

In some alternative arrangements, in an example of a “reversal ofparts,” physical guide entry slot 184 and physical guide slide slot, andaccordingly digital guide entry slot 174 and digital guide slide slot175 respectively, may be shaped in the form of guide plate 212 whereasthe guide plate may be shaped in the form of the physical guide entrysuch that the new form of the guide plate slides within the physicalguide entry slot.

With reference to FIGS. 19A and 19B showing working teeth 190A beforeand working teeth 190B after preparation using system 100, when guideplate 212 is slid between opposing ends of the physical guide slideslot, the cutting edges of shaft 211 of dental bur 210 remove toothstructure from the working tooth to be treated to form prepared surfaces185 corresponding to a digital prepared surface, such as preparedsurface 155, of a digital working tooth, such as digital working tooth150. In some arrangements, a restoration (or a plurality ofrestorations), such as but not limited to a veneer, may be prepared tohave an outer surface at least substantially corresponding to an outersurface of original working tooth 190A and to mate with prepared surface185 of prepared working tooth 190B such that upon attachment of therestoration to the prepared surface, the combination of the preparedworking tooth with the restoration is at least substantially similar tooriginal working tooth 190A. In some arrangements, the restoration mayhave an outer surface that is customized but noticeably different, e.g.,more cosmetically desirable to a patient, than the outer surface oforiginal working tooth 190A. In still other arrangements, therestoration may be an “off-the-shelf” configuration in which a preparedsurface of a working tooth to be treated may be formed to mate with sucha restoration using a physical guide device corresponding to a digitalguide device fabricated using building application 135 with thespecialty tool package in which the configuration of the surface of therestoration for mating with the prepared surface of the working tooth isincluded as an input in preparing the digital guide device.

As shown in FIG. 20, process 300 prepares a working tooth or workingteeth to receive a restoration. At block 310, a physical model of aplurality of teeth in the mouth of a patient is scanned by a suitablescanner. At block 320 and following the step at block 310, tooth datacorresponding to digital topography of the scanned physical model of theplurality of teeth is received by one or more processors of a clientcomputer, such as second client computer 130, which may receive thetooth data from first client computer 120. At block 330 and followingthe step at block 320, cutting path data corresponding to a cutting pathto be followed by a dental cutting tool based on the tooth data isstored by one or more processors of the client computer. At block 335and following the step at block 320, cutting depth data corresponding toa cutting depth to be reached by the cutting tool based on the toothdata is stored by one or more processors of the client computer. Thesteps at blocks 330 and 335 may be performed in any order, includingsimultaneously. At block 340 and following the step at block 320,initial cutting guide data corresponding to a cutting guide shellstructure for placement around a portion of a tooth to be treated andbased on the tooth data is determined by one or more processors of theclient computer. At block 350 and following the steps at blocks 330 and335, cutting tool path data corresponding to preset limits on toolmovements to be made by the cutting tool is determined by one or moreprocessors of the client computer based on the cutting path data and thecutting depth data. At block 360 and following the steps at blocks 340and 350, a first Boolean operation between the initial cutting guidedata and the cutting tool path data is performed by one or moreprocessors of the client computer to define final cutting guide datacorresponding to final cutting guide structure for guiding the cuttingtool. At block 370 and following the step at block 360, a second Booleanoperation is performed between the final cutting guide data and initialinstrument configuration data corresponding to a fixation instrumentconfiguration for fixing dental instrumentation, which is for use inguarding the cutting tool to remove tooth structure from the tooth to betreated, to an adjacent tooth to the tooth to be treated. In thismanner, final instrument configuration data corresponding to the finalinstrument configuration for releasably fixing the dentalinstrumentation to the adjacent tooth and for guiding the cutting toolin the removal of the tooth structure for the tooth to be treated isdefined. At block 380 and following the step at block 370, the finalinstrument configuration data is exported to a data storage fileconfigured for use with an AM or CAM device. At block 390 and followingthe step at block 380, the final instrument configuration is fabricatedusing an appropriate CAM or AM device.

PART 2: Digital Preparation of Placement Guide Devices for Placing aRestoration

Advantageously, in conjunction with the preparation of a digital guidedevice, such as the digital guide device 170 described previouslyherein, and accordingly a physical guide device corresponding to thedigital guide device, a placement guide device for applying arestoration, such as but not limited to a placement tray for applying aveneer, to the working teeth within a patient's mouth may be prepared.As noted above, in some arrangements, a corresponding restoration, suchas a set of veneers also may be prepared. Referring now to FIGS. 21 and22, a prepared 3D model, such as prepared 3D model 139C, including adigital working tooth with a digital prepared surface, such as digitalworking tooth 150 with digital prepared surface 155 for example or theset of digital working teeth 250 with respective digitally preparedsurfaces as shown, and a digital model of the restoration orrestorations, such as digital restorations 295 as shown, to be appliedto the respective tooth or teeth of the patient may be merged andimported into building application 135 with the specialty tool packageas restored tooth data. In this manner, as shown in FIG. 22, restored 3Dmodel 400, which corresponds to the restored tooth data and as shown maybe a digital clay model, of the patient's teeth corresponding to thedesired form of the patient's teeth, through the use of the restorationor restorations, may be generated in preparation for modeling aplacement guide device, i.e., retention splint, to appropriately placethe restoration or restorations in a patient's mouth.

Referring now to FIGS. 23A and 23B, the user of building application 135may provide an input, such as by clicking an icon on the GUI of thespecialty tool package, to perform a block out on the restored 3D modelto detect the undercut areas of digital working teeth 250 and toestablish an insertion path (and, in some instances, setting within thebuilding application an insertion axis) for a model placement guidedevice in order to remove undercuts from the restored 3D model and thusform modified restored 3D model 400A. As in this example, buildingapplication 135 with the specialty tool package removes such undercutsautomatically based on the designation of the insertion axis. In thismanner, restored 3D model 400A includes surfaces that may be used toconform a model placement guide device corresponding to a physicalplacement guide device that may be passively placed over and fitted ontoa patient's teeth without exerting any pressure or at least anysignificant amount of pressure. Once restored 3D model 400A is finalizedas desired, as shown in FIGS. 24A-24C, the user of building application135 may provide an input, such as by clicking an icon on the GUI of thespecialty tool package, to covert restored 3D model 400A from a claymodel to buck, i.e., blocked out, model 400B.

With reference to FIGS. 25A and 25B, the user of building application135 may provide an input, such as by clicking an icon on the GUI of thespecialty tool package, to select a design tool in order to drawboundary 402, i.e., an extreme edge or extreme edges, corresponding toinitial primary support configuration data for the digital occlusalsurface support, i.e., digital primary support discussed further herein,for the placement tray to be fabricated. As in the example, suchboundaries may be but are not limited to being drawn sufficiently arounddigital support teeth 452, which as shown may be opposing digitalmolars, such that building application 135 with the specialty toolpackage understands the boundaries to be intended to be closedboundaries. In this manner, portions of the placement tray to befabricated that will be placed over teeth not requiring restoration andthat may provide the most stabilization and positioning of thefabricated placement tray are digitally defined.

As shown in FIG. 26, the user of building application 135 may provide aninput, such as by clicking an icon on the GUI of the specialty toolpackage, to select a design tool in order to draw a sufficiently closedboundary 404 corresponding to initial lingual support configuration datafor the digital lingual or palatal body support, i.e. digital lingualauxiliary support, for the placement guide device to be fabricated. Asin this example, such a boundary may be but is not limited to beingdrawn sufficiently around the digital lingual side of digital workingteeth 450 and preferably down to or near the set of digital gumlines405. In this manner, portions of the fabricated placement guide deviceintended to contact the working teeth requiring restoration, and in someinstances adjacent teeth of those working teeth that may not be in needof a restoration, are digitally defined. As shown, sufficiently closedboundaries 402 and 404 may intersect with each other.

Referring now to FIG. 27A, the user of building application 135 mayprovide an input, such as by clicking an icon on the GUI of thespecialty tool package, to select a design tool in order to identify theregion within boundary 402 around digital support teeth 452 to beembossed, i.e. thickened away from the digital support teeth. As shownin FIG. 27B, building application 135 with the specialty tool package,upon receiving an input from the user, then embosses the region withinboundary 402 and away from digital support teeth 452 by adding digitalclay within the boundary as well as adding digital clay, by apredetermined distance, in a direction away from the boundary to formdigital primary support 460 corresponding to final primary supportconfiguration data.

As illustrated in FIG. 28, the user of building application 135 mayprovide an input, such as by clicking an icon on the GUI of thespecialty tool package, to select the embossing design tool in order toidentify the region within boundary 404 around the digital lingual sideof digital working teeth 450 to be embossed. As shown in FIG. 29,building application 135 with the specialty tool package is then used toemboss the region within boundary 404 and away from digital workingteeth 450 by adding digital clay within the boundary as well as, by apredetermined distance, in a direction away from the boundary to formdigital lingual auxiliary support 462 corresponding to final lingualsupport configuration data.

Still referring to FIG. 29, as in this example, the user of buildingapplication 135 may provide an input, such as by clicking an icon on theGUI of the specialty tool package, to select a drawing tool to adddigital clay between digital primary support 460 and digital lingualauxiliary support 462 to connect and form digital intersection 466(shown in FIG. 30) corresponding to lingual connecting supportconfiguration data between these supports. With reference to FIG. 30,the digital surfaces of any one or any combination of digital primarysupport 460, digital lingual auxiliary support 462, and digitalintersection 466 are smoothened as needed. In this manner, potentialrough edges that may otherwise be formed during eventual fabrication ofthe physical placement guide device are reduced or eliminated, andpotential patient discomfort due to such edges is accordingly reduced oreliminated.

Referring now to FIGS. 31A and 31B, the user of building application 135may provide an input, such as by clicking an icon on the GUI of thespecialty tool package, to select a design tool in order to draw asufficiently closed boundary 406 corresponding to initial buccal supportconfiguration data for the digital buccal or labial support, i.e.,digital buccal auxiliary support, for the placement guide device to befabricated. As in this example, such a boundary may be but is notlimited to being drawn sufficiently around a portion of the digitalbuccal side of digital working teeth 450 and preferably over anapproximately central region of the digital working teeth. In thismanner, portions of the fabricated placement guide device that willcontact the one or more restorations are digitally defined. As shown,sufficiently closed boundaries 402 and 406 may be near or intersect witheach other.

With reference to FIG. 32, the user of building application 135 mayprovide an input, such as by clicking an icon on the GUI of thespecialty tool package, to select the embossing design tool in order toidentify the region within boundary 406 around the digital buccal sideof digital working teeth 450 to be embossed. As shown, buildingapplication 135 with the specialty tool package is used to emboss theregion within boundary 406 and away from digital working teeth 450 byadding digital clay within the boundary as well as, by a predetermineddistance, in a direction away from the boundary to form digital buccalauxiliary support 464 corresponding to final buccal supportconfiguration data.

Referring now to FIG. 33A, as in this example, the user of buildingapplication 135 may provide an input, such as by clicking an icon on theGUI of the specialty tool package, to select a drawing tool to adddigital clay between digital primary support 460 and digital buccalauxiliary support 464 to connect and form digital intersection 467corresponding to buccal connecting support configuration data betweenthese supports. With reference to FIG. 33B, the digital surfaces of anyone or any combination of digital primary support 460, digital buccalauxiliary support 464, and digital intersection 467 are smoothened asneeded. In this manner, potential rough edges that may otherwise beformed during eventual fabrication of the physical placement guidedevice are reduced or eliminated, and potential patient discomfort dueto such edges is accordingly reduced or eliminated.

Referring to FIGS. 34A and 34B, the user of building application 135with the specialty tool package may provide inputs to the buildingapplication to prepare, in the same manner digital primary support 460,digital lingual auxiliary support 462, and digital buccal auxiliarysupport 464 are prepared, occlusal connector configuration datacorresponding to one or more digital connector supports 465 configuredfor contacting the one or more digital restorations, and preferably asin this example configured for wrapping around the digital restorations,to support the digital restorations. Digital connector supports 465extend between, and initially or with the use of additional digital clayintersect with digital lingual auxiliary support 462 and digital buccalauxiliary support 464. In this manner, when the physical placement guidedevice is formed, connector supports corresponding to digital connectorsupports 465 support the restorations corresponding to the digitalrestorations. As further shown, digital connector supports 465 arespaced apart along digital working teeth 450 of restored 3D model 400B.In this manner, physical connector supports corresponding to digitalconnector supports 465 may provide support for the restorationscorresponding to the digital restorations and may provide visibility ofthe teeth corresponding to digital working teeth 450. As such, thephysical connector supports may allow for flossing of or otherwisecleaning, such as of excess adhesive, in between restorations, e.g.,veneers, corresponding to the digital restorations, and in particularafter tag curing, i.e., partially curing, such as by light exposure, therestorations to the working teeth. Furthermore, physical connectorsupports corresponding to digital connector supports 465 allow forexcess flowable luting cement, e.g., a photosensitive curable cement,used for placing the physical restorations to flow between the connectorsupports. In this manner, the excess cement may be removed by a dentist,e.g., using brushes, prior to its curing while the cement is in theliquid stage and thus more easily removable. Digital surfaces of any oneor any combination of digital connector supports 465, digital lingualauxiliary support 462, and digital buccal auxiliary support 464 aresmoothened as needed to generate initial retention splint datacorresponding to rough digital placement guide device 468.

Referring to FIG. 35, the user of building application 135 may providean input, such as by clicking an icon on the GUI of the specialty toolpackage, to select a tool to dive, i.e., separate, rough digitalplacement guide device 468 from restored 3D model 400B, i.e., in thisexample, to separate the clay mesh model from the buck model. Withreference to FIG. 36, the user of building application 135 may providean input, such as by clicking an icon on the GUI of the specialty toolpackage, to select a tool to remove undesired portions, i.e. to “clean,”rough digital placement tray 468, thus generating final retention splintdata corresponding to final digital placement guide device 470, whichmay be a final digital placement tray as shown in FIG. 37.

With reference to FIGS. 37 and 38, the file size of final digitalplacement guide device 470 is reduced and the reduced file is convertedand electronically stored as an .STL file or other compatible file foruse with a CAM or AM device, such as on second client computer 130 ornetwork 140 of system 105. With reference to FIG. 39, in somearrangements, the stored .STL file corresponding to final digitalplacement guide device 470 is processed in an AM device, which may be a3D printer in the MP series by 3D Systems, Inc., to form a correspondingphysical placement guide device.

Physical placement guide devices, such as placement trays, formed by wayof the process described previously herein may take but are not limitedto taking the form of any of the physical placement trays shown in FIGS.40A-40C. Physical placement tray 510 includes primary supports 512corresponding to digital primary supports, lingual auxiliary support 514attached to and extending between the primary supports as well ascorresponding to a digital lingual auxiliary support, buccal auxiliarysupport 516 attached to and extending between the primary supports aswell as corresponding to a digital buccal auxiliary support, and spacedapart connector supports 518 attached to and extending between thelingual and buccal auxiliary supports corresponding to digital connectorsupports. Physical placement tray 610 is substantially similar tophysical placement tray 510 with the notable exception that some of theconnector supports, in this example connector supports closer to digitalprimary supports, of physical placement tray 610 are only attached to abuccal auxiliary support of physical placement tray 610. In this manner,physical placement tray 610 has some obstructed openings in contrast tophysical placement tray 510. The connector supports of physicalplacement trays 510, 610, such as connector supports 518, providesupport for restorations, e.g., veneers, and provide visibility of theteeth to which they are fitted. In this manner, such physical connectorsupports allow for the possibility to floss in between the restorationsafter tag curing the restorations to the working teeth. Furthermore,such physical connector supports allow for excess flowable luting cementto flow between the connector supports such that the cement may beremoved by a dentist as discussed above.

As shown in FIG. 40C, physical placement tray 710 includes primarysupports 712 corresponding to digital primary supports as well as acombination of a lingual auxiliary support corresponding to a digitallingual auxiliary support, a buccal auxiliary support corresponding to adigital buccal auxiliary support, and connector supports correspondingto digital connector supports that together define holes 720 through thephysical placement tray. The connector supports of physical placementtray 710 allow for adhesive for placing restorations in placement tray710 and for partially cured cement adhering the restorations to theworking teeth to pass through the holes during fixation of suchrestorations. As further shown, holes 720 may be prepared such that setsof between two and six holes of physical placement tray 710 correspondto each working teeth of a patient to be treated.

With reference to FIG. 41, in some arrangements, a dentist or preferablya technician in a dental laboratory sets restorations, e.g., veneers, ona physical model of a plurality of teeth of a patient to be treated andthen applies temporary photosensitive adhesive 498 to an inner region ofa physical placement tray intended for receipt of restorations. Thephysical placement tray is then properly placed onto the restorationsand the physical model such that the restorations are seated into fittedgrooves of the placement tray corresponding to the restorations. In someinstances, the restorations may be depressed against adhesive 498 tomore firmly attach the restorations to the placement tray. Thecombination of the placement tray and the restorations seated in andfixed to the tray are then removed from the physical model.

With reference to FIGS. 42A and 42B, a dentist applies dental cement ora permanent (strong) adhesive to a prepared surface of working teeth ofa patient, or to a lingual side of restorations to be placed in themouth of the patient, and subsequently applies the physical placementtray with the adhered restorations over the working teeth such that theappropriate grooves of the physical placement tray align with thecorresponding working teeth and such that the restorations adhered tothe corresponding teeth of the patient. The adhesive between therestorations and the teeth is then tag cured, generally in the cervicalregion of the teeth, and the excess adhesive is removed as much aspossible through and around the placement tray while the adhesive ismore easily movable. The adhesive is then fully cured, and then theplacement tray is separated from the mounted restorations and removedfrom the mouth of the patient. An example of the difference in thecosmetic look of a patient before placement of a restoration and aftersuch placement is provided in FIGS. 43A and 43B.

As shown in FIG. 44, process 800 prepares a physical placement tray toreceive a restoration and sets the physical placement tray over workingteeth of a patient using the placement tray. In some arrangements,process 800 may follow process 300. At block 810 of process 800, a 3DCAD model of unrestored and restored teeth combining a tooth to betreated and a restoration applied to the tooth to be treated is mergedvia one or more processors of a client computer, such as second clientcomputer 130, to create restored tooth data. At block 820 and followingthe step at block 810, initial primary support configuration datacorresponding to a digital model outline of instrument fixation supportstructure based on restored tooth data is stored by one or moreprocessors of the client computer. At block 830 and following the stepat block 810, initial lingual support configuration data correspondingto a digital model outline of instrument lingual support structure basedon the restored tooth data is stored by one or more processors of theclient computer. At block 840 and following the step at block 810,initial buccal support configuration data corresponding to a digitalmodel outline of instrument buccal support structure is stored by one ormore processors of the client computer. The steps at blocks 820, 830,and 840 may be performed in any order including simultaneously. At block825 and following the step at block 820, final primary supportconfiguration data corresponding to the instrument fixation supportstructure is stored by one or more processors of the client computer. Atblock 835 and following the step at block 830, final lingual supportconfiguration data corresponding to the instrument lingual supportstructure is stored by one or more processors of the client computer. Atblock 845 and following the step at block 840, final buccal supportconfiguration data corresponding to the instrument buccal supportstructure is stored by one or more processors of the client computer. Atblock 850 and following the steps at blocks 835 and 845, occlusalconnector configuration data corresponding to occlusal surfaceconnectors attached to both the instrument lingual support structure andthe instrument buccal support structure is stored by one or moreprocessors of the client computer. At block 860 and following the stepat block 850, the final primary support configuration data, the finallingual support configuration data, the final buccal supportconfiguration data, and the occlusal connector configuration data iscombined by one or more processors of the client computer to defineinitial retention splint data corresponding to a rough retention splintconfiguration. In some arrangements, at block 870A and following thesteps at blocks 825 and 835, lingual connecting support configurationdata corresponding to lingual connecting support structure connectingthe instrument fixation support structure to the instrument lingualsupport structure is stored by one or more processors of the clientcomputer. In some arrangements, at block 880A and following the steps atblocks 825 and 845, buccal connecting support configuration datacorresponding to buccal connecting support structure connecting theinstrument fixation support structure to the instrument buccal supportstructure is stored by one or more processors of the client computer. Atblock 860A and following the steps at block 850 and the steps at eitheror both of blocks 870A and 880A, the final primary support configurationdata, the final lingual support configuration data, the final buccalsupport configuration data, the occlusal connector configuration data,and either or both of the lingual connecting support configuration dataand the buccal connecting support configuration data, as appropriate, iscombined by one or more processors of the client computer to defineinitial retention splint data corresponding to a rough retention splintconfiguration. At block 890 and following the steps at either of blocks860 and 860A as appropriate, the initial retention splint data may beseparated from the restored tooth data to form final retention splintdata corresponding to a final retention splint configuration. At block895 and following the step at block 890, the final retention splint datamay be exported by one or more processors of the client computer to adata storage file configured for use with a CAM or AM device. At block899 and following the step at block 895, a retention splint, for exampleany one of physical placement trays 510, 610, 710, may be fabricated ona CAM or AM device based on the data storage file.

Based on aforementioned information, this technology provides forproducing a restoration part, in advance of the physical revision of thetooth so that the restoration part is available to the dentist evenbefore he or she starts physically preparing the tooth. The tooth canthen be prepared with precision by using the configured overlay torevise the tooth in a manner to correspond to or mate with the interiorof the restoration. The availability of the restoration makes itpossible to mount it directly onto the tooth in the same visit that thetooth is prepared. This substantially reduces the inconvenience of thepatient and reduces the number of visits made to the dentist. This alsoreduces the possibility of a prepared tooth becoming contaminated duringthe extended time period between tooth preparation and installation ofthe final restoration.

It is to be understood that the disclosure set forth herein includes allpossible combinations of the particular features set forth above,whether specifically disclosed herein or not. For example, where aparticular feature is disclosed in the context of a particular aspect,arrangement, configuration, or embodiment, that feature can also beused, to the extent possible, in combination with and/or in the contextof other particular aspects, arrangements, configurations, andembodiments of the invention, and in the invention generally.

Although the invention herein has been described with reference toparticular embodiments, it is to be understood that these embodimentsare merely illustrative of the principles and applications of thepresent invention. It is therefore to be understood that numerousmodifications may be made to the illustrative embodiments and that otherarrangements may be devised without departing from the spirit and scopeof the present invention as defined by the appended claims.

1. A method for treating a working tooth to be treated in the mouth of apatient, the method comprising: securing a guide device onto one or moreteeth of the patient; inserting a drive shaft and a connector of acutting device into the guide device, the connector being insertedthrough a first side opening of the guide device, the connector defininga connector width, the first side opening defining a first width, thefirst width of the first side opening being greater than the connectorwidth; inserting a flange of the cutting device in a directiontransverse to a longitudinal axis of the drive shaft into a slot of theguide device, the slot being in communication with the first sideopening of the guide device, the slot having a slot width within a firstplane transverse to the longitudinal axis of the drive shaft and along adirection the flange extends when the flange is inserted into the slot,the slot width being greater than the first width of the first sideopening within a second plane parallel to the first plane and along thedirection the flange extends when the flange is inserted into the slot;moving the cutting device to remove portions of the working tooth inpreparing a working surface of the working tooth, wherein translationalmovement of the cutting device is limited by the guide device tomovements parallel to the first plane and to a thickness of the slotextending in a direction perpendicular to the first plane; removing theflange of the cutting device from the slot; removing the guide devicefrom the mouth of the patient; and securing, by an adhesive, arestoration to the working surface.
 2. The method of claim 1, whereinthe securing of the restoration to the working surface includes securinga retention splint retaining the restoration onto a neighboring tooth ofthe patient such that the restoration is retained against the workingsurface of the working tooth.
 3. The method of claim 2, wherein thesecuring of the retention splint includes retaining the restoration ontodistal teeth of the patient such that the restoration is retainedagainst the working surface of the working tooth.
 4. The method of claim1, wherein the restoration is a dental crown, a dental bridge, or adental veneer, and wherein the cutting device includes a dental bur. 5.The method of claim 1, wherein a drive head of the cutting device isexterior to the guide device when the flange of the cutting device isfully inserted into the slot of the guide device.
 6. The method of claim1, wherein the guide defines a second side opening extending from theslot opposite the first side opening, and further comprising insertingthe drive shaft within the second side opening.
 7. The method of claim6, wherein the second side opening defines a second width and the driveshaft defines a shaft width, the shaft width being less than the secondwidth such that, when the cutting device is received within the guide,movement of the dental instrument is limited only by the contact betweenthe flange and the slot.
 8. The method of claim 7, wherein the firstwidth of the first side opening is greater than the second width of thesecond side opening.
 9. The method of claim 7, wherein the second widthof the second side opening is substantially constant along a length ofthe second side opening.
 10. The method of claim 6, wherein the firstside opening defines a first height, the slot defines a slot height, andthe second side opening defines a second height, wherein the secondheight is greater than both of the first height and the slot height. 11.The method of claim 1, wherein the securing of the guide device onto theone or more teeth includes using a bonding agent to secure the guidedevice to the one or more teeth.
 12. The method of claim 1, wherein thesecuring of the guide device onto one or more teeth includes receivingthe one or more teeth of the patient through a first side of the guidedevice, wherein the inserting of the drive shaft and the connector ofthe cutting device into the guide device includes inserting the driveshaft and the connector of the cutting device through a second side ofthe guide device, and wherein the first side is opposite the secondside.
 13. The method of claim 1, wherein the securing of the guidedevice onto one or more teeth includes receiving the one or more teethof the patient through a first side of the guide device, wherein theinserting of the drive shaft and the connector of the cutting deviceinto the guide device includes inserting the drive shaft and theconnector of the cutting device through a second side of the guidedevice, and wherein the first side is transverse to the second side. 14.The method of claim 1, wherein securing the guide device onto one ormore teeth of the patient includes receiving the one or more teeth ofthe patient through a first opening of the guide device.
 15. A methodfor treating a working tooth to be treated in the mouth of a patient,the method comprising: securing a first surface of a guide device ontoone or more teeth of the patient; inserting a drive shaft of a cuttingdevice into an opening of the guide device; inserting a flange of thecutting device in a direction perpendicular or otherwise transverse to alongitudinal axis of the drive shaft into a slot of the guide device,the slot being in communication with the opening of the guide device,the slot having a first dimension within a first plane perpendicular orotherwise transverse to the longitudinal axis of the drive shaft andalong a direction the flange extends when the flange is inserted intothe slot that is greater than a corresponding second dimension of theopening within a second plane parallel to the first plane and along thedirection the flange extends when the flange is inserted into the slot;moving the cutting device to remove portions of the working tooth inpreparing a working surface of the working tooth, wherein movement ofthe cutting device is limited by the guide device to directions withinthe first plane and to a thickness of the slot extending in a directionperpendicular to the first plane; removing the flange of the cuttingdevice from the slot; removing the guide device from the mouth of thepatient; and securing, by an adhesive, a restoration to the workingsurface by securing a retention splint retaining the restoration onto aneighboring tooth of the patient such that the restoration is retainedagainst the working surface of the working tooth.
 16. The method ofclaim 15, wherein the securing of the retention splint includesretaining the restoration onto distal teeth of the patient such that therestoration is retained against the working surface of the workingtooth.
 17. The method of claim 15, wherein the restoration is a dentalcrown, a dental bridge, or a dental veneer, and wherein the cuttingdevice includes a dental bur.
 18. The method of claim 15, wherein thesecuring of the guide device onto the one or more teeth includes bondingthe guide device with a bonding agent to the one or more teeth.
 19. Themethod of claim 15, wherein the securing of the guide device onto one ormore teeth includes receiving the one or more teeth of the patientthrough a first side of the guide device, wherein the inserting of thedrive shaft and the connector of the cutting device into the guidedevice includes inserting the drive shaft and the connector of thecutting device through a second side of the guide device opposite thefirst side.
 20. The method of claim 15, wherein the securing of theguide device onto one or more teeth includes receiving the one or moreteeth of the patient through a first side of the guide device, whereinthe inserting of the drive shaft and the connector of the cutting deviceinto the guide device includes inserting the drive shaft and theconnector of the cutting device through a second side of the guidedevice transverse to the first side.